Provider Demographics
NPI:1962508820
Name:PAPILLON, LUCY CASWELL (PHD)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:CASWELL
Last Name:PAPILLON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 PACIFIC COAST HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-2752
Mailing Address - Country:US
Mailing Address - Phone:310-784-5564
Mailing Address - Fax:310-376-7771
Practice Address - Street 1:2309 PACIFIC COAST HWY STE 101
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-2752
Practice Address - Country:US
Practice Address - Phone:310-784-5564
Practice Address - Fax:310-376-7771
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8413103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CP8413BMedicare ID - Type Unspecified